The strong message at a conference satellite meeting was that antiretroviral prevention methods are not in competition with each other.

Delegates were discussing the rapidly changing landscape of HIV prevention methods that use antiretroviral drugs.

Using the right prevention technology to suit the needs of the individual emerged as a theme of the meeting.

“Is treatment always the best option [as the prevention measure] in the serodiscordant couple? If the index partner can’t or won’t take pills, or if the HIV-negative partner is having concurrent partners, they might need PrEP or a microbicide,” said Professor Myron Cohen of the University of North Carolina, who was a leading researcher in the study that showed early treatment reduced the risk of transmission to an HIV-negative partner by 96%.

Engaging at-risk populations was highlighted as a major challenge.

“We need to reach out to women who don’t perceive themselves to be at risk, and we should be getting communities to rally round to be early adopters of tenofovir [microbicide] gel,” said Samu Dube of the Global Campaign for Microbicides.

There was also concern that more work needs to be done with service providers to convince them that they have a role in expanding the awareness of at-risk individuals of the treatment-based prevention methods that are becoming available.

“Providers can be major gatekeepers,” said Catherine Hankins of UNAIDS.

It will be necessary to identify the best way to use the new treatment-as-prevention products, the meeting was told.

Equally important will be the development of strategies to overcome social, legal and health-system barriers that could reduce the impact of the technologies.